Radiology Coding Alert

To the delight of radiology practices and patients, CMS is considering virtual colonoscopy coverage for colorectal cancer screening.

The current rule: "CMS covers colorectal cancer screening for average-risk individuals age 50 and older using fecal occult blood testing, sigmoidoscopy, colonoscopy, and barium enema (42 CFR 410.37)," according to CMS (http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=220).

Change rationale: As reported in Radiology Coding Alert, Vol. 10, No. 7, the American Cancer Society and the American College of Radiology contributed to new cancer screening guidelines in March, including a recommendation that virtual (computed tomography) colonography be an acceptable option for colorectal cancer screening. Remember: You report a screening with 0066T (Computed tomographic [CT] colonography [i.e., virtual colonoscopy]; screening) and a diagnostic service with 0067T (... diagnostic).

CMS expects to complete the national coverage analysis by February 2009 with a proposed decision memo as early as November. The public comment period closes June 18.